{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T13:47:49Z","timestamp":1777643269122,"version":"3.51.4"},"reference-count":36,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Facial Plastic Surgery &amp; Aesthetic Medicine"],"published-print":{"date-parts":[[2024,7,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Noma is a gangrenous infection of the face that results in severe facial deformity, occurring primarily in malnourished and impoverished populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To assess clinician- and patient-reported outcomes (PROs) before and after reconstructive surgery for patients with noma in northwest Nigeria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Objective outcomes were recorded using the noma-specific NOITULP (nose, outer cheek, inner cheek, trismus, upper\/lower lip, particularities) classification system. PROs were recorded using a locally developed tool. Postsurgical changes were assessed by Wilcoxon signed-rank testing. Linear regression was used to look for associated risk factors. The inter-rater reliability (IRR) of the NOITULP score was assessed using the weighted kappa statistic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Forty-nine patients (median age 25 years, 71% male) underwent local\/regional flap reconstruction and\/or trismus release. Twelve complications were reported. Univariate analysis showed a 3.20 change in PRO score (95% confidence interval 0.59 to 5.81,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.018) per kilogram the patient underwent at time of surgery. The NOITULP score improved from a presurgery median of 3.5 to 2.3 (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), however, the IRR was poor (kappa\u2009=\u20090.0894,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). The PRO score also improved from a median of 7.0 to 12.0 (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Facial reconstructive surgery improves the NOITULP score and PROs in patients with noma in northwest Nigeria.<\/jats:p>\n                    <jats:p>Clinical Trial Registration: OCA017-63.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/fpsam.2023.0079","type":"journal-article","created":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T15:10:05Z","timestamp":1710861005000},"page":"488-496","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prospective Outcomes of Noma Facial Reconstructive Surgery in Sokoto, Nigeria"],"prefix":"10.1177","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4779-0308","authenticated-orcid":false,"given":"Mohana","family":"Amirtharajah","sequence":"first","affiliation":[{"name":"Medicines Sans Fronti\u00e8res-Netherlands, Amsterdam, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Olaleye","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res, Noma Children's Hospital, Sokoto, Nigeria."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bukola","family":"Oluyide","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res, Abuja, Nigeria."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annick","family":"Lenglet","sequence":"additional","affiliation":[{"name":"International Centre for Antimicrobial Resistance Solutions, Copenhagen, Denmark."},{"name":"Antimicrobial Research Unit, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cono","family":"Ariti","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine, London, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elise","family":"Farley","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res, Noma Children's Hospital, Sokoto, Nigeria."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Winters","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, John Hunter Hospital and New South Wales, New Lambton Heights, New South Wales, Australia."},{"name":"Department of Otolaryngology-Head and Neck Surgery, Tulane University, New Orleans, Louisiana, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdurrazaq Olanrewaju","family":"Taiwo","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria."},{"name":"Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7786-7812","authenticated-orcid":false,"given":"David A.","family":"Shaye","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res, Noma Children's Hospital, Sokoto, Nigeria."},{"name":"Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye &amp; Ear, Harvard Medical School, Boston, Massachusetts, USA."},{"name":"Department of Surgery, University Teaching Hospital of Kigali, Kigali, Rwanda."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,7,26]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.16-0718"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.5539\/gjhs.v8n4p53"},{"key":"e_1_3_5_4_2","volume-title":"Noma is a severe disease: It is treatable if detected and managed early! 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